最近审阅: 25 十月 2020
最近更新: 14 八月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 存在的主要危险因素
  • 高血压发病年龄>55 岁
  • 急进性、恶性或难治性高血压病史
  • 不明原因的肾功能障碍病史
  • 多支冠状动脉病变史
  • 其他外周血管疾病史
  • 腹部血管杂音
  • 突然或不明原因的复发性肺水肿
  • 高血压发病年龄<30 岁

其他诊断因素

  • 无高血压家族史
  • 其他杂音
  • ACE 抑制剂或血管紧张素 II 受体拮抗剂给药后发生的急性肾损伤病史
  • 不明原因的充血性心力衰竭病史
  • 难治性心绞痛
  • 低钾血症史

危险因素

  • 血脂异常
  • 吸烟
  • 糖尿病
  • 女性

诊断性检查

首要检查

  • 血清肌酐
  • 血清钾
  • 尿液分析和沉积物评估
  • 醛固酮与肾素比值
更多 首要检查

需考虑的检查

  • 多普勒超声
  • 钆增强磁共振血管造影(MR Angiography, MRA)
  • CT 血管造影术
  • 传统血管造影术
  • 二氧化碳(CO2)血管造影
  • 非增强磁共振血管造影
  • 卡托普利放射核素肾扫描
更多 需考虑的检查

治疗流程

撰稿人

Interventional Cardiology Fellow

Mount Sinai Hospital

New York

NY

利益声明

RM declares that he has no competing interests.

Assistant Professor of Medicine

University of Massachusetts Medical School

UMass Memorial Medical Center

Worcester

MA

利益声明

AA declares that he has no competing interests.

RM and AA would like to gratefully acknowledge Dr Manmeet Singh and Dr Scott J. Gilbert, previous contributors to this topic. MS and SJG declare that they have no competing interests.

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Associate Professor

Department of Family Medicine

University of Texas Health Science Center

Tyler

TX

利益声明

RT declares that he has no competing interests.

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

利益声明

IM declares that he has no competing interests.

Professor

Aberdeen Royal Infirmary

Foresterhill

Scotland

利益声明

JW declares that he has no competing interests.

Grover E. Murray Professor

University Distinguished Professor

Texas Tech University Medical Center

Lubbock

TX

利益声明

NAK declares that he has no competing interests.

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